May 30, 2014
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Combining conductive keratoplasty, corneal collagen cross-linking improves visual outcomes

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MILAN — Combining the use of corneal collagen cross-linking with conductive keratoplasty led to stable vision improvement, according to a speaker here.

Corneal collagen cross-linking (CXL) stops keratoconus progression but yields mild vision improvement, Roy S. Rubinfeld, MD, said at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.

Roy Rubinfeld

Roy S. Rubinfeld

Combining CXL with CK was inspired by patients who claimed to have sharper vision after CXL if they pressed on specific points of the cornea through the inferior eyelid. Due to the shrinkage produced by heat, CK can reproduce and maintain those same effects by making the cornea flatter and rounder, according to Rubinfeld.

“With Richard L. Lindstrom, MD, we performed the procedure on several patients and we are now collecting long-term data,” Rubinfeld said. “We were surprised to see that the effect was maintained over time. CK was abandoned some years ago because it didn’t last, but obviously cross-linking makes corneal tissue become stiffer, and this prevents regression.”

Richard Lindstrom

Richard L. Lindstrom

Rubinfeld showed several examples, including a patient with 20/80 preoperative vision who achieved 20/20 vision 1 month after the procedure. Refraction improved from 6 D to 1D at 6 months.

“The effect not only is maintained, but improves over time. We were excited to see that at 1 year it continued to get better in several patients,” he said “If needed, more CK spots can be added to enhance the effect.”

Disclosure: Rubinfeld is an owner and shareholder of CXLUSA.